Richard Selwyn Francis Schilling

Richard Schilling was born in Kessingland, Suffolk, where his father, George Schilling, was a general practitioner. Like many general practitioners’ sons, Richard sought to follow in his father’s footsteps and studied medicine at St Thomas’s Hospital Medical School. However, when his father died suddenly in 1934, shortly after he had obtained the conjoint board’s qualification, he had to take over the practice so it could be sold as a going concern, before he had gained sufficient experience to settle down as a principal for life. Consequently, after the sale, he obtained appointments as an obstetric house physician at St Thomas’s and as a house physician at Addenbrooke’s, Cambridge. Anxious to get married and without the funds, he took an industrial medical officer’s post with ICI and became, two years later, a medical inspector of factories. When war broke out he was called up and sent with the British Expeditionary Force to France as a lieutenant in the field ambulance unit. By the time of his evacuation from Dunkirk the incidence of industrial disease resulting from the pressure of production in general and of munitions in particular had become a problem of national importance. Doctors with any experience of industrial medicine were few and the War Office directed him back to the Medical Inspectorate of Factories from which, two years later, he was seconded to serve as scientific secretary of the Medical Research Council’s industrial health research board and the direction of his post war career was settled.

The mid 1940s were exciting years for industrial medicine. The Medical Research Council established a department for research in the subject at the London Hospital, an industrial medical research unit in Birmingham, a pneumoconiosis research unit in Cardiff and a toxicology unit in conjunction with the Ministry of Supply at Porton, while academic departments were established at Glasgow, Manchester and Newcastle Universities. Opportunities for an academic career abounded, but Schilling wanted more specialist training and when he was awarded a Nuffield foundation fellowship he took a diploma in public health at the London School of Hygiene and Tropical Medicine while participating in field studies under the inspiring leadership of Donald Hunter [Munk’s Roll, Vol.VII, p.288] at his newly established department in the London Hospital. He then obtained in 1947 an appointment as lecturer in Ronald Lane’s [q.v.] department of occupational health in Manchester.

Schilling’s first task was to create an occupational health service at the Simon Engineering Group for Lord Simon who, in addition to his industrial responsibilities, had become chairman of the University Council; but it was not long before he realized that Manchester had a pressing problem in the respiratory disease of cotton workers. That cotton workers were peculiarly subject to respiratory disease had been known for a hundred years, but it had been confused with the chronic bronchitis that commonly affected the general population and the origin of the disease was controversial. Schilling carried out a field study that established the high prevalence of what is now known as byssinosis, its clinical characteristics, and its contribution to the high death rate of cotton workers, and he showed that it could be prevented by reducing the amount of dust to which cotton workers were exposed. Later he showed, in a series of international studies, that the disease also occurred in other countries where its existence had been denied. A second major contribution was to uncover the exceptionally high mortality of trawlermen, due principally to accidents, and to point to ways in which it could be reduced from personal observation when accompanying them at sea in ugly weather. A third was to demonstrate an increased mortality from coronary heart disease among viscose spinning workers exposed to carbon disulphide. This was highly controversial at the time and was only accepted after similar work had been carried out in Finland.

In 1956 Schilling became the director of the Rockefeller unit of occupational health at the London School of Hygiene and Tropical Medicine which became an Institute in 1970 on receipt of an endowment for an information centre from the Trades Union Congress. The Institute rapidly achieved international status and by the time of his retirement in 1976 over four hundred students from many countries had been educated in it and the book that he and his colleagues had written on occupational health practice had become a standard textbook for health professionals. As director he was frequently called in as a consultant to the World Health Organization and he became the unchallenged doyen of the field, as Donald Hunter had been twenty years before. The Institute, however, failed to thrive under his successors and lack of university support caused it to be closed in 1990.

Shortly before his death Schilling completed a personal book entitled A challenging life (Canning Press, 1997), giving an account of how he came into occupational medicine and the controversies with which he had to deal throughout his career. In it he made a special plea for the establishment of an occupational health service, like that recommended by the International Labour Office in 1985 and subsequently created in Finland.

It was not, however, for his contributions to medicine alone that he was remembered by his many students and friends, but also his personal qualities, his commanding presence combined with a gentleness in practice and a concern for others, and a highly developed sense of fun that made his company a constant delight. Had his decision to abandon general practice and accept an appointment in industrial medicine not led to such a successful academic career it would still have been the most important he had ever made, for it enabled him to marry Heather Norman, with whom he had fallen in love when she was eighteen and he was a medical student, and to enjoy sixty years of an outstandingly happy marriage. He died of prostate cancer at home under her care, supported by his son (also an occupational physician) and two daughters.